Relationship between CT enhancement degree and multiple vascular parameters of microvessels and mature vessels of renal clear cell carcinoma / 实用放射学杂志

Objective To elucidate the correlation between the enhancement degree of renal clearcell carcinoma (RCC) on dynamic contrast-enhanced CT and multiple vascular morphometric characteristics including microvessels and mature vessels.Methods A retrospective review was carried out on the records of 37 patients pathologically diagnosed with RCC who underwent plain and triphasic contrast-enhanced CT.The absolute (enhancement attenuation-pre-enhancement attenuation) and relative(absolute enhancement value÷cortex enhancement attenuation) enhancement values of RCC were measured in arterial,venous and delayed phases.And all lesions were divided into hypervascular and hypovascular groups.The number,mean area,perimeter and diameter,shape factor (4π*area/perimeter2) and the total area of microvessels and mature vessels were obtained by CD34 or a-SMA immunohistochemical staining.Then the correlation of radiographic parameters and various vascular morphometric parameters were analyzed.Results In arterial,venous and delayed phases,the absolute enhancement values were positively correlated with the number and the total area of microvessels and mature vessels (P0.05).In addition, the significant differences in the number of microvessels and mature vessels between hypervascular and hypovascular groups were found (P<0.05).Conclusion CT enhancement degrees of RCC are related to multiple vascular morphometric indicators,which gives us more insights in the mechanism of RCC enhancement on CT.

Lithophagia as a clue for celiac disease: a case report and literature review

Lithophagia is a type of pica that might be resulted from Iron Deficiency Anemia [IDA]which is the frequent presenting signs of Celiac Disease [CD]. A 5-year-old child with a two year history of the lithophagia with a, refractory IDA, abdominal distention and constipation. The child did not grow well and had failure to thrive. With suspicion to CD, TTg IgA level was measured and due to an incearse of TTg IgA level the patients were undergone esophagogastrodeudonoscpy and jejunal biopsy. The biopsy showed severe villous atrophy and an increase in limphoplasma cells. Biopsy confirmed diagnosis of CD and glutten free diet was initiated finally. Six months after diagnosis and commencing the gluten free diet, the lithophagia and constipation in patient eradicated completely. IDA and failure to thrive were improved and the level of TTg IgA was reached to the normal. The case demonstrated the relationship between lithophagia and CD in anemia. Therefore, in the same cases such as our case should be considered CD as the most important causes of lithophagia

Serologic evaluation of celiac disease in patients with beta thalassemia major and control

This study reports evaluated prevalence of CD in patients with Beta-thalassemia major. Celiac Disease [CD] is an autoimmune disorder triggered by ingestion of gluten in genetically predisposed individuals. In this case-control study in a period of 3 years, which was performed on 620 children in two groups of Beta-thalassemia major patients [n=200] and control [n=420], serum tissue transglutamianse [tTG] IgA levels were measured. The two groups were compared together in terms of tTG IgA levels, and p<0.05 was considered significant. The means of serum tTG IgA levels in patients with Beta-thalassemia major and control groups were 28.81+/-68.44 and 6.94+/-6.68 U/mL, respectively. There was a significant difference in favor of the case group [p=0.000]. Body mass index in the two case and control groups had a significant difference [t=3.859, p=0.001]. Belonging to each group will change the probability of having less than 20 in tTG IgA [odds=0.285] and it means that belonging to the control group has a protective role. There is only a significant association in the case of all population [r=0.102, p=0.011]. Body mass index in the two case and control groups had a significant difference [t=3.859, p=0.001]. Probability of CD should be considered since the prevalence of CD is high in patients with and Beta-thalassemia major. Patients with thalassemia major are recommended for screening for CD

Combination of erythromycin and propranolol for treatment of childhood cyclic vomiting syndrome: a novel regimen

This study aimed to evaluate the erythromycin efficacy in childhood cyclic vomiting syndrome. Cyclic vomiting syndrome [CVS] is an unusual cause of episodic emesis in children and erythromycin is an effective treatment. In this prospective study, 301 patients with a final diagnosis of CVS enrolled in two separated groups. The first group received erythromycin for 7 days and propranolol for at least 9 months [n=155]. The second group was treated with propranolol alone for at least 9 months [n=146]. These two groups were compared for response to the treatment and the recurrence of symptoms after treatment completion. Relationship of response, recurrence, and characteristics of the disease was assessed. Both groups showed a significant difference in terms of response to treatment [P=0.002], however the recurrence after treatment completion had no considerable difference [P=0.563]. There was no relationship between CVS characteristics and these two items [response and recurrence]. In our point of view, the addition of erythromycin to standard propranolol treatment can improve the response to treatment, although it has no significant effect on recurrence of CVS symptoms. We suggest the use of erythromycin for 7 days in addition to CVS standard therapy

Serological evaluation of celiac disease in children with congenital heart defect; a case control study

Due to the increased prevalence of celiac disease in chromosomal anomalies and other congenital anomalies, this study was conducted to evaluate the seroprevalence of celiac disease [CD] in patients with congenital heart defects [CHD]. This case-control study was done on 1002 children in two groups of CHD patients [n=402] and controls [n=600]. The serum tissue transglutamianse [TTG] levels were investigated. The two groups were compared in terms of TTG IgA levels and p<0.05 was considered as the significant level. The means of serum TTG IgA levels in children with CHD and the control groups were 19.17 +/- 46.67 and 7.77 +/- 10.02 u/mL respectively [p=0.001]. After ANOVA analysis a significant difference between two cyanotic and acyanotic subgroups of cases and control groups was observed [p=0.000]. The follow up tukey test showed only non-significant difference between the cyanotic and acyanotic cases. The frequency of TTG IgA with the consideration of 20 u/mL as cut-off point showed a significant association with groups [X2=28.31 and p=0.000]. According to the results the serum TTG IgA levels were significantly higher in patients with CHD than normal children and screening for CD in children with CHD is recommended

Mortality risk prediction by application of pediatric risk of mortality scoring system in pediatric intensive care unit

The Pediatric Risk of Mortality [PRISM] score is one of the scores used by many pediatricians for prediction of the mortality risk in the pediatric intensive care unit [PICIT]. Herein, we intend to evaluate the efficacy of PRISM score in prediction of mortality rate in PICU. In this cohort study, 221 children admitted during an 18-month period to PICU, were enrolled. PRISM score and mortality risk were calculated. Follow up was noted as death or discharge. Results were analyzed by Kaplan-Meier curve, ROC curve, Log Rank [Mantel-Cox], Logistic regression model using SPSS 15. Totally, 57% of the patients were males. Forty seven patients died during the study period. The PRISM score was 0-10 in 71%, 11-20 in 20.4% and 21-30 in 8.6%. PRISM score showed an increase of mortality from 10.2% in 0-10 score patients to 73.8% in 21-30 score ones. The survival time significantly decreased as PRISM score increased [P<0.001]. A 7.2 fold mortality risk was present in patients with score 21-30 compared with score 0-10. ROC curve analysis for mortality according to PRISM score showed an under curve area of 80.3%.PRISM score is a good predictor for evaluation of mortality risk in PICU

Respiratory diseases burden in the United Arab Emirates

Respiratory diseases affect individuals worldwide and United Arab Emirates [UAE] is no exception. The burden of respiratory diseases is varied, and over the past two decades several studies have been carried out across UAE to estimate the load of respiratory diseases in the area and compare this with the international respiratory disease burden. The purpose of the present study was to compile the results of studies conducted in UAE in order to obtain an overview of the situation in this area. Comparison of the respiratory toe status in UAE and internationally will improve our knowledge about the situation, which will help us to implement strategies for improved respiratory care and respiratory disease outcome at a reasonable cost

[Comparative study of early maladaptive schemas of opium dependence and non dependence men]

One of the most important factors related to onset and maintenance of substance abuse is early maladaptive schemas. The present study was conducted to compare early maladaptive schemas in opium dependence and non dependence people. This study was carried out in 2011 among men [aged 15-65 years] of Zahedan [Iran]. Overall 240 participants were asked to complete the Young Schemas Questionnaire-short form. One hundred and twenty of participants were recruited from people who met DSM-IV criteria of substance dependence disorder and other 120 subjects selected from general population [men, aged 15-65 years] of Zahedan. This research was post expose factorand in addition to descriptive methods was used t tests method to data analysis compare. Results have shown that substance dependent patients had significantly higher scores for most maladaptive schemas including disconnection, impaired autonomy, performance and over-vigilance than non dependent people [P<0.01]. Because maladaptive thoughts are core beliefs and they develop in early years of life and hypothesized to play a significant role in development of substance use, thus preventive and treatment strategies for addressing the maladaptive and dysfunctional thoughts highly recommended

[Postpartum depression and related factors: a 4.5 months]

One of the mental disorders in pregnancy and the period after it, is postpartum depression which can be a threat for security and health of mother and infant. With regard to this matter the study was conducted to investigate the prevalence of postpartum depression and related factors. This research is a descriptive-analytical study which was conducted in gynecology and obstetric department in Imam Ali Hospital in Zahedan city, Southeast of Iran. The participants were 300 women selected randomly and were evaluated four times [immediately after delivery, 4 weeks after the first assessment, 6 weeks after the second assessment and 8 weeks after the third assessment] with Beck Depression Inventory and demographic questionnaire. Mother under treatment for psychological problem, mother whose babies present serious health problem, BDI score less than 14 and mothers don't have number for calling was excluded from the study. The data was analyzed by SPSS. In this study 33.7% were depressed and it was observed that there was a significant relation between the mother age, kind of delivery, infant's gender, mother' education, history of previous depression and psychotropic drugs using [P<0.05]. Postpartum depression is relatively frequent. Adjustment of any of factors which have role in this disorder, can be useful in decreasing the incidence of the illness

Differential inhibitory potencies of alcoholic extract of different parts of Dryopteris chrysocoma on inflammation in mice and rats

Phytomedicinal therapy for inflammation is not new and it is highly effective for the treatment of various inflammatory disorders. The inflammation is one of the initial parameter for most of the disorders occurring in the body. The anti-inflammatory potential can be determined by using various techniques. Dryopteris chrysocoma is a male fern commonly found in damp and moist areas of Pakistan. The study was conducted on mice and rats by inducing inflammation with subcutaneous administration of formalin and Carrageenan in hind paw. The results were compared with standard drug Aspirin administered orally in the dose of 300 mg/kg and a decrease in hind paw volume was observed. The intensity of edema was observed in mice after formalin injection and the time of disappearance of edema was observed. In rats the inhibition of inflammation by root, leaves and stem extract was 51.19%, 41.66% and 30.95% respectively after administration of formalin. Similar inhibition of inflammation produced by root, leaves and stem extracts i.e. 57%, 42% and 35% respectively in Carrageenan treated rats. Root extract showed the highly significant results at p

[ gap between perception and expectations of patients of quality of treatment centers in Zahedan by using the Servqual model]

To survey of the gap between perceptions and expectations of patients from quality service of treatment center. This study is descriptive-analytical that is cross-sectioned of goal oriented with 200 patients [at least with 3 days admission in the hospital of Zahedan] that was studied with parasoraman and et al questionnaire in 2 stages, before care and after care, one time perception and the other time they said self expectation about quality of treatment services. Based on the findings research there are differences between the average scores of perception and expectation in all aspects of quality and this means health centers in any of the five branches of the services quality components have not been able to respond to the level of patient expectations and Quality perceived is less than expected. The difference between perceptions and expectations of quality of treatment services in tangible dimensions were [-69%], confidence [-0.685], responsiveness [-0.795], assurance [0.755], empathy [-0.84], overall quality [-0.775]. Finding show the gap between current condition and desired condition of treatment services that could reduce with the planning, management, proper training. Medical staff should always consider this content that Patients expect for them in addition to the drug therapy, kindness, sympathy and compassion, confidence, respect, and also the sense of responsibility

[On the relationship between mental health, spiritual intelligence and dysfunctional attitudes in students of Systan and Baluchestan University, Southeast of Iran]

The main objective of this research was to investigate the relationship between dysfunctional attitude, spiritual intelligence and their effect on mental health in students of Systan and Baluchestan University in 2009-2010. Our sample was included of 370 students [108 males and 255 females] which were assessed with the Spiritual Intelligence Self-Report Inventory-24 [SISRI-24], Dysfunctional Attitudes Scale [DAS] and General Health Questionnaire [GHQ]. The data have been analyzed by Pearson correlation coefficient and regression analysis. There are significant positive correlations between SISRI-24 scores and GHQ scores [P<0.01] and significant negative correlations between DAS scores and GHQ scores and between DAS scores and SISRI-24 scores [P<0.01]. Based on the regression analysis, both spiritual intelligence and dysfunctional attitudes scores could predict students' mental health. Students' spiritual intelligence dysfunctional attitudes correlate with their mental health

Maternal and Neonatal Serum Zinc Level and Its Relationship with Neural Tube Defects.

Neural tube defect (NTD) is a multi-factorial disorder in which nutritional, genetic and environmental factors are involved. Among the nutritional factors, low level of serum zinc has been reported from different parts of the world. This hospital-based case-control study was conducted with the objective of finding the relationship between serum zinc level in newborns and their mothers and NTDs in a Bangladeshi population. The study was conducted during August 2006–July 2007 at the Bangabandhu Sheikh Mujib Medical University (BSMMU) in Dhaka. In total, 32 mothers and their newborns with NTDs were included as cases and another 32 mothers with their normal babies were included as controls. Concentration of serum zinc was determined by pyro-coated graphite furnace atomic absorption spectrophotometer (GF-AAS). The mean age of the case and control mothers was 25.28 years and 24.34 years respectively. The mean gestational age of the case newborns was 36.59 weeks and that of the control newborns was 37.75 weeks. The mean serum zinc level of the case and control mothers was 610.2 μg/L and 883.0 μg/L respectively (p<0.01). The mean serum zinc level of the case and control newborns was 723 μg/L and 1,046 μg/L respectively (p<0.01). In both case and control groups, the serum zinc level of the newborns positively correlated with that of the mothers. The serum zinc levels of the mothers and newborns negatively correlated with NTDs. Mothers with serum zinc level lower than normal were 7.66 [95% confidence interval (CI) 2.5-23.28] times more likely to have NTDs compared to the normal zinc level of mothers. After adjusting for the zinc level of the newborns, parity, and age of the mothers, this risk reduced 1.61 times [confidence interval (CI) 95% 0.24-8.77]. On the other hand, the low serum zinc level of the newborns was 7.22 times more associated with NTDs compared to the newborns with the normal serum zinc level, which was statistically significant (p=0.001). After adjusting for other factors, such as maternal age and parity, newborns with the low serum zinc level was found to be 9.186 times more likely to be associated with NTDs compared to newborns with normal serum zinc level. Based on the findings, it may be concluded that the low serum zinc levels of newborns may be associated with NTDs. To confirm these findings, a further study with a larger sample-size is recommended. Moreover, a follow-up study with zinc supplementation to pregnant women and its impact on NTDs is also recommended.

acute effects of Dokha smoking on the cardiovascular and respiratory systems among male university students

To assess the acute effects of dokha smoking on the cardiovascular and respiratory systems among male university students in the UAE. A quasi-experimental study was conducted during the months of November-December, 2009 among 97 male volunteers aged more than 17 years. Blood pressure, heart rate and respiratory rate of each participant, were measured before and immediately after smoking. A self administered questionnaire was used to collect personal details and data about smoking pattern. Mean increases in systolic bloc pressures [12 +/- mmHg], heart rates [20 +/- bpm] and respiratory rates [4 +/- 1 breaths/min] were observed [p< 0.001]. A mean decrease in diastolic blood pressures [1 +/- 1 mmHg] was observed [p = 0.483] smoking dokha has a significant acute effect on systolic blood pressure, heart rate and respiratory rate. Anti smoking campaigns must address the ill effects of this form of smoking. Results from the study warrant further research in this method of smoking which is becoming popular

Carcinoma rectum: presentation and outcome of different treatment modalities

To find out different presentations of carcinoma rectum and efficacy of different methods of its treatment. Three years observational prospective case study of 42 cases of Carcinoma of Rectum was conducted in Liaquat University Hospital, Jamshoro and people's Medical College Hospital, Nawabshah from June 2005 to May 2008. All the patients were assessed comprehensively and underwent for surgical intervention accordingly. The age ranged between 20-90 years of the 42 patients with mean age 52 years and male to female ratio was 2:1. 40.4% cases presented with bleeding per rectum and 21.4% with altered bowel habits. More than 50% tumour was located in lower third of rectum. Regarding Duke's classification, 40 [95.23%] were in C and D stages. Out of 42 cases, 21 [50%] were underwent with colostomy, 5 [11.9%] by anterior resection, 7 [16.6%] by abdomino-perineal resection and [11.9%] by Hartman's procedure. Wound infection seen in 28.8%, urinary tract infection in 19.2% and colostomy complications in 20.6%. All the patients with bleeding per rectum should be referred to the hospitals for early evaluation and proper management. Late referral and diagnosis make life miserable with permanent stoma in our social setup

experience of day care surgery in general surgical unit at people's medical college hospital, Nawabshah

To determine the feasibility of surgical procedures performed as 'day care cases' and their complications. An observational prospective study was conducted in the Department of surgery unit-Il, People' Medical College Hospital, Nawabshah from January 2002 to December 2007. A total of 1440 patients had undergone day care surgery During a period of 05 years. Surgery was carried out under local anaesthesia, local anaesthesia and sedation, regional Anaesthesia and general anaesthesia in children. Excision of skin and subcutaneous lesions were the commonest procedures performed [40%]. Complications Were observed of less significant. The hospitalization rate was [4%], which was unplanned. Significant number of elective procedures, minor and medium, can be performed as 'day care cases'. This does reduce the hospital admission burden

Frequency of hypocalcaemia in thyroid surgery

To determine the frequency of hypocalcaemia in thyroid surgery. This prospective study has been conducted at Surgical-IV in Liaquat University Hospital, Jamshoro/Hyderabad and Surgical Unit-II in Peoples Medical College, Nawabshah over a period of Two years from February 2006 to January 2008. This is a hospital based case series of 100 patients, who underwent subtotal, near total and total thyroidectomy for benign and malignant thyroid lesions. The age of the patients ranged between 15-70 years with mean age 32 years. 85 patients are female and 15 are male. In 18 patients, out of 100, hypocalcaemia has been observed clinically as well biochemically. It is concluded that frequency of hypocalcaemia is significant but only a few of them present with symptoms and permanent hypoparathyroidism is very rare

[Comparison of Islamic oriented and classical cognitive behavioral therapy on mental health of martyrs' and veterans' wives]

The present study was planned to assess the effectiveness of cognitive behavioral therapy emphasized on religious believes to relieve psychological problems of wives of martyrs and veterans. In a double-blind clinical trial in Zahedan city, south-eastern part of Iran during 2008-9, 60 individuals from wives of martyrs and veterans who had obtained abnormal General Health Questionnaire-28 [GHQ-28] scores and their anxiety and depression had been proved through a clinical interview, were selected by accessible sampling method and randomly divided to three equal groups. The first, the second and the third groups received 8 sessions of classical cognitive-behavioral therapy, 8 sessions of Islamic oriented cognitive-behavioral therapy and no intervention respectively. The study instruments included GHQ-28 and Dysfunction Attitude Scale, which were executed for each subject at the baseline and after the interventions. The scores were analyzed using ANCOVA statistical method. There were significant differences of scores between three groups [P<0.01]. Although there were significant differences of improvement scores of two cases groups in comparison with control group [both with P<0.01], but there was no significant difference between scores of two cases groups [P>0.05]. The findings exhibited that cognitive-behavioral therapy emphasized on islamic approach bears the same effects of classical behavioral therapy

Clinical analysis of EEG parameters in prediction of the depth of anesthesia in different stages: a comparative study

Evaluation of depth of anesthesia is especially important in adequate and efficient management of patients. Clinical assessment of EEG in the operating room is one of the major difficulties in this field. This study aims to find the most valuable EEG parameters in prediction of the depth of anesthesia in different stages. EEG data of 30 patients with same anesthesia protocol [total intravenous anesthesia] were recorded in all anesthetic stages in Shohada-e-Tajrish Hospital. Quantitative EEG characteristics are classified into 4 categories of time, frequency, bispectral and entropy-based characteristics. Their sensitivity, specificity and accuracy in determination of depth of anesthesia were yielded by comparing them with the recorded reference signals in awake, light anesthesia, deep anesthesia and brain dead patients. Time parameters had low accuracy in prediction of the depth of anesthesia. The accuracy rate was 75% for burst suppression response. This value was higher for frequency- based characteristics and the best results were obtained in beta spectral power [accuracy: 88.9%]. The accuracy rate was 89.9% for synch fast slow bispectral characteristics. The best results were obtained from entropy-based characteristics with the accuracy of 99.8%. Analysis of the entropy-based characteristics had a great value in predicting the depth of anesthesia. Generally, due to the low accuracy of each single parameter in prediction of the depth of anesthesia, we recommend multiple characteristics analysis with greater focus on entropy-based characteristics